Giant cell arteritis in African Americans

Giant cell arteritis is often considered less common in African Americans. In 1985, we reviewed 34 African American patients with biopsy-proven tempor al arteritis. We report on 9 additional biopsy positive patients seen at th e Washington Hospital Center (WHC) between 1988 and 1996. Clinical presentations were similar to those reported in previous series, w ith the exception that only one patient had polymyalgia rheumatica. Two pat ients had visual symptoms, but only one patient had permanent monocular vis ual loss. In combining our 9 new patients with 41 biopsy-proven, well chara cterized, published patients and comparing them with a representative Cauca sian group, we found statistically significant differences. Male gender, an emia, and visual loss were overall more common in African Americans, wherea s constitutional symptoms and polymyalgia rheumatica were less common. The detection rate of temporal artery biopsies at WHC was lower than rates repo rted in other studies, but they did not differ by race. We conclude that giant cell arteritis should be pursued as a diagnosis in a ll patients presenting with appropriate clinical features, regardless of ra ce, and that earlier recognition may account for the lower incidence of per manent visual loss.